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and had more body cell mass than previous HIV men, but less than controls (p < .001). In women, the sport between group differences in fat were greater than the differences in body cell mass. Current and previous HIV study subjects had lower indices of subcutaneous and higher indices of visceral fat sport than controls. In current HIV subjects, body fat distribution was significantly associated with log plasma HIV RNA content but not with antiretroviral or protease inhibitor usage, nor with CD4+ sport lymphocyte counts. In 7 of 9 current HIV subjects studied, 24-hour urinary free cortisol excretion was abnormally high. CONCLUSIONS: Alterations in body fat distribution are a characteristic feature in HIV infection. The occurrence of increased visceral fat content and decreased subcutaneous fat content preceded the era of combination antiretroviral therapy. The alteration in fat distribution may be affected by plasma HIV RNA content rather than antiretroviral or protease-inhibitor therapy.
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